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CVS - Coggle Diagram

- - - - Volume changes
      - Pressure changes
    - - ECG (P, QRS, T)
      - 1st, 2nd, 3rd degree heartblock, AF, VF, ST Elevated MIC
      - Heart conduction (SA, AV, Bundles of His, etc.)
  - - - systole, diasystole
      - Stroke volume = EDV-ESV
      - Pulse pressure
      - Mean arterial pressure (MAP)
      - Regulation
        
        Short term
        
        Long term (RAAS)
        
        CO= SV x HR
        
        Preload / Frank Starling law
        
        Afterload
        
        Contractility
  - - - Hands and arms
      - Skin
      - Face and eyes
      - Neck
      - Oedema
- - - - Short term (SNS)
        
        Beta receptor
        
        Heart rate increase
        
        Cardiac output
        
        Alpha receptor
        
        Vasoconstriction
        
        Peripheral restriction
      - Long term (RAS)
        
        Renin
        
        Angiotensin
        
        Aldosterone
        
        Sodium and water retention
    - - Diuretics
      - sympathoplegics
        
        α-blocker:
        Prazosin
        
        β-blocker:
        PropranOLOL
      - Vasodilators:
        
        Minoxidil
        
        Actions:dilate aterioles
        
        K channel opener > block calcium > vaso dilation
        
        treatment of severe to malignant hypertension
        
        Reflex sympathetic stimulation, sodium/water retention
      - Angiotensin
        antagonists
        
        ACE
        inhibitor (PRIL)
        
        Reduce sodium/water retention (no adolsterone)
        
        Vasodilation (no Bradykinin)
        
        Clinical use: Hypertension, cardiac failure, MI
        
        Adverse effect:
        hypotension, acute renal failure,
        hyperkalemia, angioendema
        Dry cough (bradykinin)
        
        Contraindication: Pregnancy
        
        AT1-R
        blocker (SARTAN)
        
        Less dry cough
        Contraindication: Pregnancy
      - Calcium channel blocker
  - - - Preload
        
        Blood volume
        
        Venous tone
      - Afterload
        
        Arterial blood pressure
      - Heart rate
      - Contractability
    - - Vasodilators:
        
        Nitrate (GTN)
        
        Nitrate oxide (NO)
        
        guanylate cyclase (GC)
        
        Cylic GMP
        (cGMP)
        
        Protein Kinase
        
        1 more item...
        
        Side effect
        
        Hypotension
        
        Tachycardia
        
        Headache
        (not enough blood to brain)
        
        Ca channel blocker
        
        Nifedipine
        
        Myocardial
        contractility
        
        Anti-angina
        
        Vascular smooth
        muscle tone
        
        Anti-hypertension
        
        Verapamil,
        Diltiazem
        
        SA/AV nodes
        
        Antiarrhythmia
        
        Adverse effect:
        
        bradycardia, AV blocker, heart failure
        
        Action
        
        Lowering BP: Verapamil=diltiazem=nifedipine
        
        Vasodilator: Nifedipine>diltiazem>verapamil
        
        Cardiac depressant: Verapamil>diltiazem>Nifedipine
      - Cardiac depressant
        
        Beta blockers
        
        B1 in heart:
        Increase rate/force
        
        B1 selective blocker: a/m/a/e/OLOL
        
        B2 in vascular muscle
        Vasodilation
        
        B1 B2 non-selective blockers: p/t/n/c/ OLOL
        
        Adverse effect:
        
        Bradycardia
        
        CNS
        
        Asthma
        
        Contraindication: diabetic
        
        Ca channel blocker
      - Antiplatelet drug
      - LIpid lowering drug
  - - - Use: (1) Pulomonary edema and other edema, (2) Acute hyperkalemia,
        (3) Acute renal failure
      - Adverse effect: (1) Hypokalemic (2) Hyperuricemia (3) Hypomagnesemia
        Avoid using with aminoglycoside antibiotic
      - Action:
        
        inhibit the luminal Na+/K+/2Cl- transporter
        
        induce renal PGs synthesis > increase renal bloodflow
        
        Can be interfered by NSAID
    - - Use: (1) Hypertension (2) Congestive heart failure
        (3) nephrogenic diabetes insipidus
      - Actions:
        
        Inhibit NaCl reabsorption by blocking Na/Cl transporter
        
        Enhance Ca reabsorption
        
        Can be interfered by NSAID
      - Adverse effect: (1) (1) Hypokalemic (2) Hyperuricemia (3) Hyperglycemia
        (4) hyperlipidemia
  - - - Diet
      - Drug
        
        Decrease secrection of lipoprotein
        
        Niacin
        
        Treat hyperlipoproteinemia
        
        Action ?
        
        Increase peripheral clearance
        
        Fibrates
        (gemfibrozil) FIBR
        
        Treat hypertriglyceridemias
        
        Action?
        
        HMG-CoA Reductase
        Inhibitors
        (lovastatin)
        STATIN
        
        Treat hyperlipidemias
        
        Adverse effect:
        
        Liver
        
        Muscle: myopathy and rhabdomyolysis
        
        Contraindication: pregnant/nursing/children/teen
        
        Action?
        
        Reduce fat absorption
        
        Resins (cholestyramine)
        
        Treat hypercholesterolemia
        
        Actions?
        
        Reduce intestinal sterol absorption
        
        Ezetimide
        
        Reduction of LDL
        
        Action?
- - - - Prehypertension / Stage 1/ Stage 2
      - Hypertensive emergence
      - Hypertensive urgency
    - - Heart and arteries
      - Kidney
      - Brain
      - Eyes
    - - Lifestyle modification
        
        Weight reduction / Exercise
        
        DASH diet/Sodium intake
        
        Moderate alcohol intake
      - Medication
  - - - Hypertension
      - Coronary Heart Disease
      - Others
    - - Right side
        
        lower body edema
        
        Distended jugular veins
      - Left side
        
        Pulmonary congestion / dyspnea
        
        Tachycardia
    - - SNS activation
      - Fluid retention
      - Hypertrophy
  - - - Atherosclerosis
        
        Insufficient O2 to heart (Ischemia)
    - - Electrocardiogram (ECG)
      - Coronary angiography
      - Treadmill exercise test
    - - ACS (Acute Coronary Syndrome)
        
        STEMI
        
        Unstable angina
      - Stable angina